Urology: BPH and obstructive uropathy Flashcards
What are Sx of BPH?
Nocturia, hesitancy, terminal dribble, intermittency, straining, incomplete emptying, frequency, urgency, weak flow
What would be in your initial assessment of man with LUTsx ?
DRE for prostate, Abdo exam for palpable bladder? Urinary frequency volume chart, urine dipstick, PSA
What is a common side effect of tamsulosin?
Postural Hypotension
What is a common side effect of finasteride?
Sexual dysfunction due to reduced androgen activity
How does obstructive uropathy present if in upper UT?
Loin to groin or flank pain on the side of obstruction. Reduced or no urine output. Non-specific Sx - vomiting. High creatinine on bloods.
How does obstructive uropathy present if in lower UT?
Hard to pass urine. Urinary retention with increasingly full bladder. High creatinine on bloods.
How is obstructive uropathy in the upper UT managed?
Nephrostomy
How is obstructive uropathy in the lower UT managed?
Urethral or suprapubic catheter.
What are complications of obstructive uropathy?
Hydronephrosis, pain, post renal AKI, CKD, infection, urinary retention and bladder distention, overflow incontinence of urine.
What is hydronephrosis?
Swelling of the renal pelvis and calyces in the kidney, caused by obstructed UT - leads to back pressure into the kidneys.
How does hydronephrosis present?
Vague renal angle pain. Mass in the area the kidneys are.
What investigations would you do for hydronephrosis?
USS, CT, IV urogram
How is hydronephrosis treated?
Treat underlying cause. Relieve the pressure: percutaneous nephrostomy and antegrade ureteric stent.
